A year after presenting his health plan, Minister Dubé presented his Bill 15, a massive 308-page document with 1,180 articles entitled “A law to make the health and welfare system more efficient”.
This bill notably confirms the creation of Santé Québec, the agency that will be responsible for activities related to the healthcare system.
This makes said agency the sole employer in the network of health and social services; this will therefore be the end of the CISSSs and CIUSSSs that will be integrated into this new structure.
It is estimated that 30 to 40% of the ministry’s 1,200 employees will transfer to the new employer in connection with the formation of Santé Québec.
The draft law also envisages the unification of human resources management in the network and the expansion of the participation of medical specialists.
“The health status quo is simply not an option. »
— A quote from Christian Dubé, Minister of Health
All professionals in the network would have to contribute to the care of the population, said the minister.
The government believes it will achieve better coordination within the network and better distribution of care and services in each region. He also believes he will be able to emphasize local decision-making by appointing the facility’s Medical Directors.
Health Minister Christian Dubé today presented his bill to reform the health system in Quebec. Interview with the minister.
Santé Québec, one employer
With the agency Santé Québec, the government is proposing to do what many reports have recommended over the past 30 years: separate the activities and orientations of the Department of Health and Social Services (MSSS).
Santé Québec will be governed by the same model as state-owned companies, which means it will have a President and Chief Executive Officer and a Board of Directors.
In addition to organizing patient care, the new agency will assume responsibility for personnel and become the sole employer for all healthcare workers. There are currently 34 different employers in the network, i.e. just as many personnel management systems.
Seniority lists are also merged. Union certifications will drop from 136 to just four.
The changes will be made in compliance with collective agreements and in cooperation with the unions, the government promises, which wants to make the network more attractive to caregivers.
For example, Quebec believes that it is not normal that a Montreal-based nurse with 20 years of experience cannot settle in another region without losing her benefits, including tenure.
The government wants to set up a mobile staff bank to help regions suffering from labor shortages.
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Manager close to the field
As well as the human resources component, Quebec says they want local management, meaning proximity to the field and teams, an aspect that has been raised during the pandemic. Indeed, some establishments did not have a manager appointed or present on site.
The government intends to correct this situation by reinstating local managers.
The bill provides for the appointment of facility medical directors and area medical directors in both family medicine and specialty medicine in each region of the province. Quebec believes this will ensure physicians become more involved in local care management.
The same applies to social services, where a social services director and a professional social services council will be set up in all institutions, explained the Minister for Social Services, Lionel Carmant.
In addition, the bill introduces new requirements for doctors to restore the balance between GPs’ and specialists’ responsibilities to the population, the government said. Mr Dubé said some doctors and specialists were putting in more than their fair share of trouble and insisted he was not looking for culprits.
An interdisciplinary council will also have the mandate to evaluate the treatment pathways and their organization in the facilities under the responsibility of Santé Québec.
Increase user satisfaction
The draft law also includes the obligation to measure the level of user satisfaction, which will allow the services to be adjusted according to the results obtained, says the government.
A national user committee will be set up; It will be responsible for harmonizing the practices of the various user committees in the establishments and will make recommendations to the Santé Québec Board of Directors.
Two weeks ago, the minister announced a pilot project to measure happiness levels in emergencies using a new scoreboard, sparking outrage from the opposition.
Another objective mentioned in relation to the draft law: the creation of a more coordinated complaints procedure thanks to the creation of a position of national complaints officer. Users would be listened to and corrections would have to be made when unacceptable situations arise, it said.
It is not normal, said Mr. Dubé, that some complaints never reach us.
This could reassure the provincial regrouping of user committees, which on Wednesday recalled the importance of this guardian of users’ rights. It is imperative that user and resident committees remain in all facilities throughout Quebec, in all facilities and for all missions, we read in a press release.